Com quantas pílulas se (re)ergue um manicômio? A medicalização nas conferências nacionais de "saúde mental".

Abstract

The Psychiatric Reform, the Antimanicomial Struggle and the Deinstitutionalization process have been historically marked by overcoming hospitalizations in asylums, building strategies and services in the community, guaranteeing rights and reflecting on the current models of care for the people served in so-called "mental health" services. From the strengthening of such processes, the hospital-centered, hygienist and medicalizing model is questioned, since it strengthens the invalidation and segregation processes of those who escape the norm and destabilize the social order imposed on them. The path has already been covered with the closure of hospitals and / or the reduction of psychiatric beds. Parallel to this, substitutive services are proposed that make it possible to reorient attention and assistance in "mental health". Despite the advances, it is necessary to look at the fact that the Psychiatric Reform can not be reduced only to the change in the physical structures that imprison bodies. On the contrary, the biggest challenge to be (constantly) confronted is the manicomial - and manicomalizing - practices that go beyond the hospital walls. Substitutive services and their professionals are still confronted in their daily practices with the challenge of breaking with therapeutic strategies coming from the hospital-centered model. In these spaces, medicalization emerges as a proposal for central intervention - when not unique - leaving in the background other possibilities that say of a practice of care based on the autonomy and rights of the people served. From this, this work aimed to identify how the problem of medicalization in "mental health" has been discussed (and tensioned) in Brazil. For that, a documentary analysis was carried out, through the thematic content analysis, of the reports of the National Mental Health Conferences. From the categories created and analyzed, it was possible to infer that although we have advanced with the proposals of the Brazilian Psychiatric Reform, as a non-watertight movement, there is much to be discussed, stressed and (re) analyzed. The dialogue on the medicalization of life seems to be in the background. Who is so interested in silence (s)? Were the asylums actually overthrown or strengthened? What are we insane asylums? These are issues that emerge and do not accept immediate answers. Therefore, the invitation to reflection.